September, 28 2023 Author : Carlos Guimarães Balanitis, posthitis and balanoposthitis are, respectively, localized inflammations and/or infections : On the glans , that is, the head of the penis, which in uncircumcised men is covered by the prepuce; In the foreskin or prepuce , that is, the skin that covers the glans in uncircumcised men; On the glans and prepuce . They are more common in adult men, although they can also happen in children, especially when foreskin opening is very tight (phimosis) and difficult to retract. Causes Balanitis, posthitis and balanoposthitis can have several causes. Poor hygiene It is the most common cause of inflammation of the glans and foreskin, especially when there is phimosis, that is, when the opening of the foreskin is tight, and its retraction is difficult. Infections More often, inflammation of the head of the penis is due to an excessive development of the Candida albicans . The presence of this fungus is normal, but situations such as poor hygiene, medication with some antibiotics, among others, may cause an imbalance in the normal flora or a weakness of the immune system and excessive development of this fungus may occur, causing genital candidiasis. Many other microorganisms – fungi, bacteria and viruses – can be the cause of inflammation at the head of the penis, including those that are the cause of sexually transmitted infections. Allergies Allergic reactions with inflammation of the glans and foreskin can have various origins, for example latex from condoms, intimate lubricants, hygiene products, fibers from clothing fabrics, residues from clothing washing products, medicines, among others. Friction Friction from repeated rubbing can also cause inflammation and can happen, for example, during sexual intercourse when lubrication is poor and when wearing very tight clothing. Phimosis In men with a tight foreskin opening, inflammation of the head of the penis is more common, because phimosis makes it difficult to maintain correct hygiene and favors the accumulation of secretions and residues that over time give rise to inflammation. Other diseases that can manifest with inflammation of the head of the penis are, for example, psoriasis, seborrheic dermatitis, lichen planus, eosinophilic balanitis and pre-malignant and malignant lesions of the penis. Diabetes is a risk factor for developing balanitis and balanitis can even be an early warning sign of diabetes. Taking some new antidiabetic drugs often increases the occurrence of balanoposthitis. Balanitis symptoms and complications The most common symptoms of inflammation and infections at the head of the penis are: Redness and swelling (edema); Itching (pruritus); Sensitivity to touch; Unpleasant odor; Burning or pain in the area and when urinating; Presence of an abnormal secretion, generally whitish or transparent, which may only be visible when the foreskin is retracted; Wounds, which often appear as longitudinal cracks in the foreskin and which cause their tightness; Ulcers and vesicles, often related to sexually transmitted diseases. The impossibility of replacing the foreskin over the glans due to its edema and strangulation (paraphimosis) is a possible complication of inflammation of the head of the penis and is a medical emergency as it can compromise circulation leading to necrosis and infection. Treatment The treatment of balanitis, posthitis and balanoposthitis depends on their cause . In some cases, it may be necessary to carry out some additional tests to determine this cause, for example an analysis of the secretion present or blood tests to identify an infection. In most cases, the diagnosis is based on clinical features. Maintaining adequate hygiene solves cases that are due to poor hygiene. When there is an infection, local medications may be needed (creams and ointments) or taken orally: antifungals if it is a fungal infection, antibiotics if the infection is caused by bacteria. When inflammation is due to an allergy, local application of corticosteroid ointments may be necessary, as well as avoiding the cause. When dealing with a sexually transmitted infection, it must be treated specifically. When the lesion is malignant or pre-malignant, it must be treated surgically. When associated with phimosis (tightening of the foreskin), surgical treatment is recommended. Balanitis prevention Always maintaining correct hygiene is the best way to prevent inflammation and complications at the head of the penis: Washing the genital area must be done daily, with warm water and neutral soap or shower gel; The glans area is exposed by retracting the foreskin, without forcing, and washed gently followed by rinsing thoroughly with water so that no residues remain; Before replacing the foreskin, the area must be dry to avoid humidity, which favors the development of microorganisms. Hygiene care after urination may be necessary in some cases. Other measures that can help prevent these inflammations: Lubrication during sexual intercourse , if necessary and if there is no allergy to its components, to reduce the consequences of friction; Wear comfortable clothing , preferably cotton and loose-fitting to allow adequate ventilation; Maintaining a good hydration , drinking water, is essential to have an adequate urinary output and avoid the local accumulation of residues that could be a cause of inflammation; Using a condom during sexual intercourse is the best measure to avoid sexually transmitted infections; In cases where tightness of the foreskin ( phimosis ) contributes to the recurrence of inflammation, correction with surgery ( circumcision ) may be necessary. Meet the urology clinical team from Hospital da Luz network The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
